关键词: 肝细胞癌, 肝切除术, 肝移植, 米兰标准, 补救性肝移植

Abstract:

Selection of liver resection and liver transplantation for patients with hepatocellular carcinoma        SHEN Feng, WANG Kui, XUE Hui, et al. Eastern Hepatobiliary Surgery Hospital，the Second Military Medical University，Shanghai 200438，China
Corresponding author：SHEN Feng, E-mail:shenfengehbh@
sina.com
Abstract    Liver resection (LR) and liver transplantation (LT) are the main radically curative treatments for hepatocellular carcinoma (HCC) currently. For patient with HCC amenable for either treatment, there is still a controversy on selection of LR or LT for tumor at different stages, particularly at intermediate stage. Studies suggested that there was no difference in overall survival between both options for HCC patients within Milan criteria (MC) ,who were optimal candidates for a curative LR. For patients with severe cirrhosis and multiple tumors (≤3) within MC, LT achieved a better long-term survival. Although evidences of comparison of long-term outcomes following both treatments for intermediate HCC beyond MC is still insufficient, several MC -expanded criteria have been proposed, especially, from China, showing optimal accuracy in selecting transplant patients. However, LR+ salvage LT may be another therapeutic strategy worthy of discussion. A well-designed, prospective study which overcomes the selection biasis is urgently required to clarify the prognostic difference between the two treatments.

Key words: hepatocellular carcinoma, liver resection, liver transplantation, Milan criteria, salvage liver transplantation